cytotoxic hazardous medications non-cytotoxic...

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is chart is taken from the WRHA Safe Handling of Hazardous Medications (Cytotoxic and Non-Cytotoxic) This chart is t Policy 110.160.010 July 2012 at http://home.wrha.mb.ca/corp/policy/files/110.160.010.pdf Please refer to this policy for more detailed information about the safe handling of hazardous medications. For the most recent version of the drug table, go to http://home.wrha.mb.ca/prog/pharmacy/drugs_safehandling.php Safe Handling of Hazardous Medications Chart Disclaimer The WRHA and CancerCare MB “Safe Handling of Hazardous Medications” chart was developed to provide direction in the safe handling of cytotoxic and non-cytotoxic hazardous medications as defined in the attached medication listing. The information presented in this chart is intended for use by staff of the WRHA and CancerCare MB only. The authors have made every effort to ensure that the information presented was accurate at the time of publication. As new research and experience broadens our knowledge, changes in handling requirements as well as the medication listing will be required. Neither the authors, reviewers, nor publishers can be responsible for errors, omissions, inconsistencies or continued completeness of the information contained in the chart or medication listing. The information in this chart and medication listing should not be used in place of the skill and professional judgment required when determining appropriate handling of these medications. Information on the medication listing will be reviewed and updated periodically, however ongoing accuracy at particular points in time cannot be assured. The onus is on the user to contact the WRHA Pharmacy Program for updates. January 2013 CYT O T O XIC HAZARD O US MEDICATI O NS NON-CYTOTO XIC HAZARDOUS MEDICATI ONS Precautions Injectable Solid Oral Dosage Form Compromised Dosage Form * Injectable Solid Oral Dosage Form Compromised Dosage Form * Receiving Pr otective wear (unpacking stock from warehouse, manufacturer , external pharmacy) Exam Gloves Exam Gloves Exam Gloves No special requirements No special requirements No special requirements P r otective wear - receiving stock that has been damaged (stock con- tents confirmed with packing slip) Chemo Gloves Procedure Mask Chemo Gown Chemo Gloves Procedure Mask Chemo Gown Chemo Gloves Procedure Mask Chemo Gown Exam Gloves Procedure Mask Exam Gown Exam Gloves Procedure Mask Exam Gown Exam Gloves Procedure Mask Exam Gown Preparation & Transport Prepared by Pharmacy Pharmacy Pharmacy Except Dissol ve & Dose Nurse (or Pharmacy f or specified medications) Pharmacy Pharmacy Except Dissol ve & Dose Preparation area Class II B2 biological saf ety cabinet or al ternate cl osed system Designated cytotoxic packaging area Designated cytotoxic packaging area Ward or Pharmacy Designated cytotoxic packaging area Designated cytotoxic packaging area Protective wear (for stapreparing the area) Chemo Gloves Shoe Covers None None None None None Protective wear (for stapreparing medication doses) Double Gloves (inner is Chemo Gl ove) Procedure Mask Chemo Gown Shoe Covers Chemo Gloves Double Gloves ( inner is Chemo Gl ove) Procedure Mask Chemo Gown Sterile Gloves (Pharmacy) Exam Gloves (Nursing) Exam Gloves Chemo Gloves Procedure Mask Exam Gown Packaging requirements (by Pharmacy) Each dose packaged separately Unit-dose Unit-dose No special requirements Unit-dose SOLIDS unit-dose LI QUIDS unit-dose or multi-dose Labeling requirements (for use in patient care area) CYTOTOXIC CYTOTOXIQUE CYTOTOXIC CYTOTOXIQUE CYTOTOXIC CYTOTOXIQUE WEAR GLOVES WEAR GLOVES DO NOT CRUSH WEAR GLOVES DO NOT CRUSH Packaging for transport (to patient care area, ot her pharmacy area, external pharmacy) Double Sealed Container (e.g. Ziploc® bags) Sealed Container (e.g. Ziploc® bag) Sealed Container (e.g. Ziploc® bag) No special requirements No special requirements No special requirements Clean-up protective wear Doubl e Gl oves ( inner is Chemo Glove) N95 Mask Protective Eye Wear Chemo Gown Shoe Covers Chemo Gloves Chemo Gloves Procedure Mask Chemo Gown Exam Gloves Exam Gloves Chemo Gloves Procedure Mask Exam Gown Administration & Disposal 1 Administration restrictions REFER TO SITE-SPECIFI C POLI CIES REFER TO SITE-SPECIFI C POLI CIES Administration precautions Chemo Gloves required Procedure Mask/ Chemo Gown recommended Chemo Gloves Chemo Gloves required Procedure Mask/ Chemo Gown r ecommended Exam Gloves Exam Gloves Do Not Crush Exam Gloves Do Not Crush Medication waste management Chemo Gl oves required Procedure Mask/ Chemo Gown recommended Chemo Gloves Chemo Gloves No additional precautions No additional precautions No additional precautions Human waste management Chemo Gloves required Procedure Mask/ Chemo Gown recommended Chemo Gloves required Procedure Mask/ Chemo Gown recommended Chemo Gloves required Procedure Mask/ Chemo Gown recommended No additional precautions No additional precautions No additional precautions Spill management REFER TO SPILL MANAGEMENT ALGORITHM (see Appendix B of WRHA Safe Handling of Hazardous Medications (Cytotoxic and Non-Cytotoxic) Policy 110.160.010 July 2012 at http://home.wrha.mb.ca/corp/policy/files/110.160.010.pdf) Chemo Gl oves required Procedure Mask/ Chemo Gown recommended Chemo Gl oves required Procedure Mask/ Chemo Gown recommended Chemo Gl oves required Procedure Mask/ Chemo Gown recommended 1 Shoe covers & protective eye wear should be worn whenever there is potential for splashing * Compromised Dosage Form: Any solid dosage form (tablet or capsule) that is changed in any way; e.g. splitting or crushing a tablet, opening a capsule to empty the powder, preparing a suspension from tablets. For the purposes of this policy all oral liquids, topical and inhalation preparations (including commercially prepared products) are considered compromised dosage forms. FORM #W-00490 03/2013

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Page 1: CYTOTOXIC HAZARDOUS MEDICATIONS NON-CYTOTOXIC …mpha.in1touch.org/uploaded/web/Legislation/Practice... · The WRHA and CancerCare MB “Safe Handling of Hazardous Medications”

is chart is taken from the WRHA Safe Handling of Hazardous Medications (Cytotoxic and Non-Cytotoxic)This chart is tPolicy 110.160.010 July 2012 at http://home.wrha.mb.ca/corp/policy/fi les/110.160.010.pdfp p p y p fPlease refer to this policy for more detailed information about the safe handling of hazardousmedications.

For the most recent version of the drug table, go tohttp://home.wrha.mb.ca/prog/pharmacy/drugs_safehandling.php

Safe Handling of Hazardous Medications Chart

DisclaimerThe WRHA and CancerCare MB “Safe Handling of Hazardous Medications” chart was developed to provide direction in the safe handling of cytotoxic and non-cytotoxic hazardous medications as defi ned in the attached medication listing. The information presented in this chart is intended for use by staff of the WRHA and CancerCare MB only. The authors have made every effort to ensure that the information presented was accurate at the time of publication. As new research and experience broadens our knowledge, changes in handling requirements as well as the medication listing will be required. Neither the authors, reviewers, nor publishers can be responsible for errors, omissions, inconsistencies or continued completeness of the information contained in the chart or medication listing. The information in this chart and medication listing should not be used in place of the skill and professional judgment required when determining appropriate handling of these medications. Information on the medication listing will be reviewed and updated periodically, however ongoing accuracy at particular points in time cannot be assured. The onus is on the user to contact the WRHA Pharmacy Program for updates. January 2013

C YTOTOXIC HAZARDOUS MEDICATIONS NON-CYTOTOXIC HAZARDOUS MEDICATIONS

Precautions Injectable Solid Oral Dosage Form

CompromisedDosage Form

pp*

Injectable Solid Oral Dosage Form

CompromisedDosage Form

pp*

ReceivingProtective wear (unpacking stock from warehouse, manufacturer,external pharmacy)

Exam Gloves Exam Gloves Exam Gloves No special requirements

No special requirements

No special requirements

Protective wear - receiving stock that has been damaged (stock con-tents confi rmed with packing slip)

Chemo Gloves Procedure Mask

Chemo Gown

Chemo Gloves Procedure Mask

Chemo Gown

Chemo Gloves Procedure Mask

Chemo Gown

Exam Gloves Procedure Mask

Exam Gown

Exam Gloves Procedure Mask

Exam Gown

Exam Gloves Procedure Mask

Exam Gown

Preparation & Transport

Prepared by Pharmacy Pharmacy Pharmacy Except Dissolve & Dose

Nurse (or Pharmacy for

specifi ed medications)Pharmacy Pharmacy

Except Dissolve & Dose

Preparation areaClass II B2 biological

safety cabinet oralternate closed system

Designatedcytotoxic

packaging area

Designatedcytotoxic

packaging areaWard or Pharmacy

Designatedcytotoxic

packaging area

Designatedcytotoxic

packaging area

Protective wear (for staff preparing the area)

Chemo Gloves Shoe Covers None None None None None

Protective wear (for staff preparing medication doses)

Double Gloves (inner is Chemo Glove)

Procedure Mask Chemo Gown Shoe Covers

Chemo Gloves

Double Gloves (inner is Chemo Glove)

Procedure Mask Chemo Gown

Sterile Gloves (Pharmacy) Exam Gloves (Nursing) Exam Gloves

Chemo Gloves Procedure Mask

Exam Gown

Packaging requirements(by Pharmacy)

Each dose packagedseparately Unit-dose Unit-dose No special

requirements Unit-doseSOLIDS unit-doseLIQUIDS unit-dose or multi-dose

Labeling requirements (for use in patient care area)

CYTOTOXICCYTOTOXIQUE

CYTOTOXICCYTOTOXIQUE

CYTOTOXICCYTOTOXIQUE WEAR GLOVES WEAR GLOVES

DO NOT CRUSHWEAR GLOVES

DO NOT CRUSH

Packaging for transport (topatient care area, other pharmacyarea, external pharmacy)

Double Sealed Container

(e.g. Ziploc® bags)

Sealed Container(e.g. Ziploc® bag)

Sealed Container (e.g. Ziploc® bag)

No special requirements

No special requirements

No special requirements

Clean-up protective wear

Double Gloves (inner is Chemo Glove)

N95 Mask Protective Eye Wear

Chemo Gown Shoe Covers

Chemo GlovesChemo Gloves

Procedure Mask Chemo Gown

Exam Gloves Exam GlovesChemo Gloves

Procedure Mask Exam Gown

Administration & Disposal1

Administration restrictions REFER TO SITE-SPECIFIC POLICIES REFER TO SITE-SPECIFIC POLICIES

Administration precautions

Chemo Gloves requiredProcedure Mask/

Chemo Gown recommended

Chemo Gloves

Chemo Gloves requiredProcedure Mask/

Chemo Gownrecommended

Exam Gloves Exam Gloves Do Not Crush

Exam GlovesDo Not Crush

Medication waste management

Chemo Gloves requiredProcedure Mask/

Chemo Gown recommended

Chemo Gloves Chemo Gloves No additional precautions

No additional precautions

No additional precautions

Human waste management

Chemo Gloves requiredProcedure Mask/

Chemo Gown recommended

Chemo Gloves requiredProcedure Mask/

Chemo Gown recommended

Chemo Gloves requiredProcedure Mask/

Chemo Gown recommended

No additional precautions

No additional precautions

No additional precautions

Spill managementREFER TO SPILL MANAGEMENT ALGORITHM

(see Appendix B of WRHA Safe Handling of Hazardous Medications(Cytotoxic and Non-Cytotoxic) Policy 110.160.010 July 2012 at

http://home.wrha.mb.ca/corp/policy/files/110.160.010.pdf )

Chemo Gloves requiredProcedure Mask/

Chemo Gownrecommended

Chemo Gloves requiredProcedure Mask/

Chemo Gownrecommended

Chemo Gloves requiredProcedure Mask/

Chemo Gownrecommended

1 Shoe covers & protective eye wear should be worn whenever there is potential for splashing* Compromised Dosage Form: Any solid dosage form (tablet or capsule) that is changed in any way; e.g. splitting or crushing a tablet, opening a capsule to empty the powder, preparing a suspension from tablets. For the purposes of this policy all oral

liquids, topical and inhalation preparations (including commercially prepared products) are considered compromised dosage forms.

FORM

#W

-004

90

03/

2013